1. A 24-year-old man asks for treatment for a red, sticky right eye. He has mild irritation, no eye pain, no photophobia, no contact lens use and normal vision. He has recently had a cold.
Which ONE of the following is the most appropriate initial management?
A. Refer urgently to emergency ophthalmology for all red eyes.
B. Supply topical corticosteroid eye drops.
C. Provide self-care advice, hygiene measures and safety-netting for likely infective conjunctivitis.
D. Start oral aciclovir.
E. Advise using old antibiotic eye drops from a previous episode.
2. A 31-year-old contact lens wearer presents with a painful red eye, watering, photophobia and slightly blurred vision. She slept in her lenses overnight.
Which ONE of the following is the most appropriate action?
A. Supply lubricating drops and advise continuing contact lens wear.
B. Treat as uncomplicated allergic conjunctivitis.
C. Supply chloramphenicol and review in one week.
D. Recommend oral antihistamine only.
E. Stop contact lens use and arrange same-day urgent eye assessment for possible keratitis.
3. A 72-year-old woman presents with sudden severe unilateral eye pain, headache, nausea, blurred vision and halos around lights. The eye is red and the pupil appears fixed.
Which ONE of the following is the most appropriate action?
A. Arrange emergency ophthalmology assessment for suspected acute angle-closure glaucoma.
B. Treat as uncomplicated bacterial conjunctivitis.
C. Recommend artificial tears and routine optician review.
D. Supply sodium cromoglicate eye drops.
E. Advise resting in a dark room and review in 48 hours.
4. A 67-year-old man has a painless bright red patch over the white of one eye. He woke with it this morning. His vision is normal and there is no trauma, discharge, photophobia or pain. He takes apixaban.
Which ONE of the following is the most appropriate pharmacist contribution?
A. Refer immediately for suspected acute glaucoma.
B. Start chloramphenicol eye drops.
C. Advise stopping apixaban permanently.
D. Reassure that this may be subconjunctival haemorrhage, but check for trauma, recurrent episodes or bleeding risk concerns.
E. Treat as herpes simplex keratitis.
5. A 19-year-old woman has bilateral itchy, watery, red eyes every spring. She also has sneezing and nasal itching. Vision is normal and there is no pain or photophobia.
Which ONE of the following is the most appropriate management option?
A. Oral antibiotics.
B. Antiallergy eye drops such as sodium cromoglicate, with advice on allergen avoidance and contact lens use.
C. Emergency referral for suspected acute glaucoma.
D. Topical corticosteroid eye drops without prescription.
E. Oral aciclovir.
6. A 58-year-old woman reports gritty, burning eyes that are worse late in the day. She uses a computer for long periods and has no discharge, pain, photophobia or reduced vision.
Which ONE of the following is the most appropriate initial management?
A. Start chloramphenicol eye ointment for 2 weeks.
B. Refer urgently for suspected retinal detachment.
C. Recommend oral antihistamine only.
D. Start topical corticosteroid eye drops.
E. Recommend lubricating eye drops and self-care measures for likely dry eye, with safety-netting.
7. A 63-year-old man has chronic irritation, crusting around the eyelashes and red eyelid margins. Symptoms are worse in the morning and vision is normal.
Which ONE of the following is the most appropriate advice?
A. Regular eyelid hygiene with warm compresses and lid cleaning.
B. Immediate emergency referral for all eyelid crusting.
C. Long-term topical corticosteroid eye drops from the pharmacy.
D. Stop washing the eyelids.
E. Use chloramphenicol indefinitely.
8. A 70-year-old woman using latanoprost eye drops for glaucoma asks why her eyelashes have become longer and the iris looks darker.
Which ONE of the following is the most appropriate explanation?
A. These effects indicate treatment failure.
B. They suggest acute angle-closure glaucoma.
C. They mean the drops should be used twice daily.
D. Prostaglandin analogue eye drops can cause eyelash growth and iris or periocular pigmentation changes.
E. They are symptoms of bacterial conjunctivitis.
9. A 66-year-old man with asthma is prescribed timolol eye drops for glaucoma. He reports increased wheeze since starting them.
Which ONE of the following is the most appropriate pharmacist action?
A. Reassure because eye drops cannot have systemic effects.
B. Query suitability because topical beta-blockers can worsen bronchospasm.
C. Advise doubling inhaled salbutamol and continuing timolol without review.
D. Recommend oral antihistamine.
E. Stop all glaucoma treatment permanently.
10. A patient is prescribed two different eye drops to be used at the same time of day. She asks how to use them.
Which ONE of the following is the most appropriate counselling point?
A. Mix both drops together in the cap before applying.
B. Apply the second drop immediately after the first to wash it in.
C. Leave an interval between different eye drops to reduce washout and improve absorption.
D. Use eye drops only when vision becomes blurred.
E. Touch the dropper tip onto the eye to improve accuracy.
11. A 74-year-old man has shingles affecting the forehead and tip of the nose. He reports eye redness and discomfort.
Which ONE of the following is the most appropriate action?
A. Treat as uncomplicated dry eye.
B. Recommend topical chloramphenicol only.
C. Advise routine review after the rash crusts.
D. Arrange urgent medical or ophthalmology assessment for possible ophthalmic shingles.
E. Supply sodium cromoglicate eye drops.
12. A 6-month-old baby has a sticky eye with mild discharge. The eye is not red, the baby is feeding well and there is no eyelid swelling or fever.
Which ONE of the following is the most appropriate advice?
A. Consider nasolacrimal duct obstruction and advise gentle cleaning, with referral if red flags or persistence.
B. Supply chloramphenicol to all infants with sticky eyes.
C. Treat as acute angle-closure glaucoma.
D. Recommend topical steroid drops.
E. Advise avoiding all face cleaning.
13. A 28-year-old man presents after a splash of household cleaning chemical into his eye 10 minutes ago. He has pain, watering and difficulty opening the eye.
Which ONE of the following is the most appropriate immediate advice?
A. Wait until the chemical name is known before doing anything.
B. Apply antibiotic eye ointment first.
C. Cover both eyes and go home.
D. Use allergy eye drops and review tomorrow.
E. Irrigate the eye immediately and arrange urgent emergency assessment.
14. A 45-year-old man reports new flashes of light, floaters and a curtain-like shadow over part of his vision in one eye.
Which ONE of the following is the most appropriate action?
A. Treat as conjunctivitis.
B. Recommend artificial tears and routine optician appointment in 1 month.
C. Arrange urgent same-day eye assessment for possible retinal detachment.
D. Supply sodium cromoglicate.
E. Advise sleeping on the affected side.
15. A 77-year-old woman reports gradual painless loss of central vision and distortion of straight lines. She describes door frames as looking wavy.
Which ONE of the following condition should be considered?
A. Blepharitis.
B. Age-related macular degeneration.
C. Bacterial conjunctivitis.
D. Acute angle-closure glaucoma.
E. Subconjunctival haemorrhage.
16. A 69-year-old man with type 2 diabetes has missed his diabetic eye screening appointments for 3 years. He says his vision is currently fine.
Which ONE of the following is the most appropriate pharmacist advice?
A. Screening is unnecessary if vision is normal.
B. Diabetic retinopathy causes symptoms before damage occurs.
C. Eye screening can be replaced by blood glucose testing.
D. Encourage attendance because diabetic eye disease can be asymptomatic until advanced.
E. Screening is only needed for people using insulin.
17. A 38-year-old woman has a painful red eye with photophobia and blurred vision. She has a history of inflammatory bowel disease.
Which ONE of the following is the most appropriate action?
A. Arrange same-day urgent assessment for possible uveitis or other serious inflammatory eye disease.
B. Treat as uncomplicated allergic conjunctivitis.
C. Recommend sodium cromoglicate only.
D. Supply chloramphenicol and review in 10 days.
E. Reassure because inflammatory bowel disease is unrelated to the eyes.
18. A 51-year-old woman asks for chloramphenicol eye drops for red eyes. She has severe eye pain, reduced vision and sensitivity to light.
Which ONE of the following is the most appropriate pharmacist action?
A. Supply chloramphenicol and advise review in 5 days.
B. Recommend lubricating drops only.
C. Treat as seasonal allergy.
D. Advise using contact lenses less often.
E. Refer urgently because pain, photophobia and reduced vision are red flags.
19. A 40-year-old man has a tender swelling at the edge of his eyelid that looks like a small pustule. Vision is normal and there is no spreading redness or fever.
Which ONE of the following is the most appropriate initial advice?
A. Start oral antibiotics immediately.
B. Refer urgently for suspected retinal detachment.
C. Use warm compresses and eyelid hygiene for likely stye, with safety-netting.
D. Apply topical corticosteroid into the eye.
E. Squeeze the lesion to drain it.
20. A 56-year-old woman has a painless lump in the upper eyelid present for 6 weeks. It is not red or tender and vision is normal.
Which ONE of the following is the most likely diagnosis?
A. Acute angle-closure glaucoma.
B. Chalazion.
C. Bacterial keratitis.
D. Allergic conjunctivitis.
E. Subconjunctival haemorrhage.
21. A 30-year-old man says he got a small metal fragment in his eye while drilling. He has pain, watering and foreign body sensation.
Which ONE of the following is the most appropriate action?
A. Recommend lubricating drops and review next month.
B. Advise rubbing the eye to dislodge the fragment.
C. Treat with sodium cromoglicate.
D. Supply chloramphenicol without assessment.
E. Arrange urgent assessment, especially because high-velocity foreign body injury may threaten the eye.
22. A 73-year-old woman using glaucoma drops admits she often misses doses because she has difficulty squeezing the bottle and forgets the evening dose.
Which ONE of the following is the most appropriate pharmacist contribution?
A. Advise stopping glaucoma treatment if symptoms are absent.
B. Recommend using drops only when vision is blurred.
C. Explore adherence barriers, demonstrate technique and consider compliance aids or referral for support.
D. Tell her missed doses do not matter in glaucoma.
E. Suggest doubling the next dose after each missed dose.
23. A patient using eye drops asks how to reduce systemic absorption because the drops sometimes leave a bitter taste.
Which ONE of the following is the most appropriate counselling point?
A. Close the eye and press gently over the inner corner after instilling the drop.
B. Blink rapidly for 2 minutes after each drop.
C. Instil extra drops to compensate for drainage.
D. Tilt the head forward while applying drops.
E. Rinse the eye immediately after each dose.
24. A 65-year-old man has chronic glaucoma and is prescribed new eye drops. He asks whether glaucoma can be stopped once eye pressure improves.
Which ONE of the following is the most appropriate advice?
A. Stop treatment once symptoms improve.
B. Glaucoma is usually chronic and treatment adherence is important to reduce risk of progressive sight loss.
C. Eye pressure does not matter in glaucoma.
D. Use drops only before optician appointments.
E. Replace drops with oral antihistamines.
25. A 5-year-old child has a red eye with thick discharge. The parent reports marked eyelid swelling, fever and pain on eye movement.
Which ONE of the following is the most appropriate action?
A. Supply chloramphenicol and review after the weekend.
B. Treat as allergic conjunctivitis.
C. Recommend eyelid hygiene only.
D. Arrange urgent medical assessment for possible orbital or periorbital cellulitis.
E. Advise school attendance as normal.
Eye Questions
Answers and Rationale
1. C
Mild red sticky eye with normal vision, no pain, no photophobia and no contact lens use is consistent with uncomplicated conjunctivitis. Self-care, hygiene and safety-netting are appropriate because many cases are self-limiting.
2. E
A contact lens wearer with a painful red eye, photophobia and blurred vision needs urgent same-day assessment for possible keratitis. Contact lens-associated keratitis can threaten vision and should not be managed as simple conjunctivitis.
3. A
Severe unilateral eye pain with headache, nausea, halos and a fixed pupil suggests acute angle-closure glaucoma. This is an ophthalmic emergency requiring immediate specialist assessment.
4. D
A painless bright red patch with normal vision is typical of subconjunctival haemorrhage. Anticoagulant use, trauma, recurrent episodes or other bleeding symptoms should be checked, but many cases resolve spontaneously.
5. B
Bilateral itchy watery eyes with seasonal rhinitis symptoms suggest allergic conjunctivitis. Sodium cromoglicate or another antiallergy preparation may help, with advice on avoiding triggers and contact lens precautions.
6. E
Grittiness and burning without pain, discharge, photophobia or reduced vision is consistent with dry eye. Lubricating drops and practical self-care measures are appropriate, with referral if symptoms are severe or persistent.
7. A
Crusting around eyelashes with red eyelid margins is typical of blepharitis. Regular eyelid hygiene with warm compresses and lid cleaning is central to management.
8. D
Latanoprost is a prostaglandin analogue. It can cause increased eyelash growth, iris pigmentation and periocular pigmentation changes, which should be discussed during counselling.
9. B
Timolol eye drops can be systemically absorbed and may worsen bronchospasm in patients with asthma or COPD. New wheeze after starting treatment should prompt review with the prescriber or eye clinic.
10. C
Different eye drops should usually be separated by several minutes to reduce washout and improve drug contact time. Patients should also avoid touching the dropper tip to the eye.
11. D
Shingles involving the forehead, tip of nose or eye symptoms can indicate ophthalmic zoster. Eye involvement can threaten sight and requires urgent assessment.
12. A
A sticky eye without conjunctival redness in an otherwise well infant may be nasolacrimal duct obstruction. Gentle cleaning and monitoring may be appropriate, with referral if infection signs or persistence occur.
13. E
Chemical eye injury requires immediate irrigation; treatment should not wait until the chemical is identified. Urgent emergency assessment is needed after initial irrigation.
14. C
Flashes, floaters and a curtain-like shadow are classic warning symptoms for retinal detachment. Same-day urgent eye assessment is required to prevent permanent vision loss.
15. B
Gradual central visual loss and distortion of straight lines are concerning for age-related macular degeneration, particularly wet AMD if symptoms are new or worsening. Prompt assessment is needed.
16. D
Diabetic retinopathy can be asymptomatic until advanced disease. Regular screening is important even when vision seems normal.
17. A
Painful red eye with photophobia and blurred vision suggests a serious cause such as uveitis. Inflammatory bowel disease is associated with inflammatory eye disease, so same-day assessment is appropriate.
18. E
Severe pain, photophobia and reduced vision are red flags in red-eye presentations. Supplying chloramphenicol without referral could delay treatment of sight-threatening disease.
19. C
A tender pustular swelling at the eyelid margin is consistent with a stye. Warm compresses and eyelid hygiene are suitable initial measures, with safety-netting for spreading redness or persistent symptoms.
20. B
A painless, non-tender eyelid lump persisting for weeks is typical of a chalazion. Warm compresses may help, but persistent, recurrent or atypical lesions need assessment.
21. E
A high-velocity metal foreign body can penetrate the eye and threaten vision. Urgent assessment is needed, and the patient should avoid rubbing the eye.
22. C
Glaucoma is often asymptomatic until advanced, so missed doses can increase risk of progression. Pharmacists can improve adherence by checking technique, identifying barriers and suggesting support tools.
23. A
Closing the eye and applying gentle pressure to the nasolacrimal duct can reduce drainage into the nose and systemic absorption. This can also reduce unpleasant taste.
24. B
Glaucoma is usually a chronic condition requiring ongoing treatment and monitoring. Eye drops should not be stopped just because symptoms are absent or pressure improves.
25. D
Red eye with marked eyelid swelling, fever and pain on eye movement suggests possible orbital or periorbital cellulitis. This requires urgent medical assessment, especially in children.
Here are 25 multiple-choice questions designed to mimic the GPHC exam itself. At the bottom of the page you will find answers and rationale for each question.