{"id":1621,"date":"2022-09-14T16:05:00","date_gmt":"2022-09-14T16:05:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1621"},"modified":"2025-10-01T11:40:31","modified_gmt":"2025-10-01T19:40:31","slug":"usmle-step-1-question-of-the-day-refractive-errors","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Refractive Errors"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#A_Hyperopia\" >A. Hyperopia&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#B_Acute_closed-angle_glaucoma\" >B. Acute closed-angle glaucoma<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#C_Astigmatism\" >C. Astigmatism&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#D_Presbyopia\" >D. Presbyopia&nbsp;<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;<\/em><\/strong><strong><em>Today&#8217;s case focuses on a 21-year-old man who has noticed some difficulty reading textbooks or viewing text on his laptop screen.&nbsp;<\/em><\/strong><strong><em>Can you figure it out?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 21-year-old man presents to his primary care physician for a routine evaluation. The patient has noticed some difficulty seeing presentation slides during his college lectures. He has not experienced difficulty reading textbooks or viewing text on his laptop screen. He is otherwise healthy and does not take any medications. Vital signs are within normal limits, and visual acuity is noted to be 20\/30 bilaterally. Which of the following is the most likely diagnosis?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Hyperopia&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Acute closed-angle glaucoma<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Astigmatism<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Presbyopia&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Myopia<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Myopia<\/strong>Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s USMLE\u00ae Step 1 Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Hyperopia\"><\/span><strong>A. Hyperopia&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Hyperopia is defined by the presence of farsightedness. This patient, on the other hand, has difficulty seeing distant objects and likely has myopia (nearsightedness).&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Acute_closed-angle_glaucoma\"><\/span>B. Acute closed-angle glaucoma<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Acute closed-angle glaucoma often presents with severe eye pain, eye redness, and a dilated pupil.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Astigmatism\"><\/span>C. Astigmatism&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Astigmatism is an abnormal curvature of the cornea. The condition manifests with difficulty seeing both near and far objects.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Presbyopia\"><\/span>D. Presbyopia&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Presbyopia, also termed age-related nearsightedness, occurs due to changes in the lens\u2019s curvature, a decline in lens elasticity, and a decrease in ciliary muscle strength. Symptoms of presbyopia generally manifest around the age of 40 and can be treated with magnifying reading glasses. In contrast, this patient is in his 20s and is unlikely to have presbyopia.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This young adult presents with difficulty seeing distant objects but not near objects. He likely has myopia, which can be treated with the application of concave lenses.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Normally, as light enters the eye, the lens bends the light so that the optical image is clearly focused on the retina. When the cornea and lens fail to optimize this focus, a distortion or blurring of the image can occur. With hyperopia (far-sightedness), the axial length of the eye is too short for the refractive power of the cornea and lens. Thus, the image is focused behind the retina. This refractive error can be corrected with a convex (converging) lens. In contrast, myopia (near-sightedness) occurs when the axial length of the eye is too long for the refractive power of the cornea and lens. These abnormalities cause the image to be focused in front of the retina. Treatment for myopia involves the application of a concave (diverging) lens.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lastly, astigmatism refers to an abnormal curvature of the cornea, which causes light rays entering the eye along different planes to be focused unevenly, resulting in distortion of vision at all distances. Treatment involves the application of a cylindrical lens.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"381\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2022\/09\/corrective-lenses.png\" alt=\"\" class=\"wp-image-4690\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2022\/09\/corrective-lenses.png 600w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2022\/09\/corrective-lenses.png?resize=300,191 300w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Myopia occurs when the eye\u2019s axial length is too long for the refractive power of the cornea and lens. The condition results in difficulty seeing distant objects since the image ends up being focused in front of the retina. Treatment involves the application of a concave lens.\u00a0<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Daiber, H.F., Gnugnoli, D.M. (2020) \u201c<em>Visual acuity<\/em>\u201d. StatPearls [Internet]. Web Address: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563298\/.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Lawrence, M.S., Azar, D.T. (2002)&nbsp;<em>Myopia and models and mechanisms of refractive error control. Ophthalmology Clinics of North America<\/em>. 15(1),127-133. Doi: 10.1016\/s0896-1549(01)00002-5.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Wallman, J., Winawer, J. (2004)&nbsp;<em>Homeostasis of eye growth and the question of myopia. Neuron.<\/em>&nbsp;43(4), 447-468. Doi: 10.1016\/j.neuron.2004.08.008.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;Today&#8217;s case focuses on a 21-year-old man who has noticed some difficulty reading textbooks or viewing text on his laptop screen.&nbsp;Can you figure it out? A 21-year-old man presents to his primary care physician for a routine evaluation. [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1622,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,1369,44],"tags":[],"class_list":["post-1621","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Refractive Errors - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-refractive-errors\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Refractive Errors - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"This week, we are sharing another USMLE\u00ae Step 1-style practice question to test your knowledge of medical topics.&nbsp;Today&#8217;s case focuses on a 21-year-old man who has noticed some difficulty reading textbooks or viewing text on his laptop screen.&nbsp;Can you figure it out? A 21-year-old man presents to his primary care physician for a routine evaluation. 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