Sclera: scleromalacia perforans: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Sclera: scleromalacia perforans

Sample item

A 65-year-old woman with long-standing rheumatoid arthritis has painless, yellow-grey scleral thinning with exposed uvea and no inflammation. This is:

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Scleromalacia perforans

Scleromalacia perforans is a painless necrotising scleritis without inflammation seen in long-standing seropositive rheumatoid arthritis. The sclera melts away with the underlying uvea showing through, and perforation is rare. Management is of the underlying disease and protecting the eye from trauma.

Option by option

  • A. Episcleritis

    Episcleritis does not thin the sclera.

  • B. Posterior scleritis

    Posterior scleritis does not give visible thinning anteriorly.

  • C. Necrotising scleritis with inflammation

    Necrotising scleritis with inflammation is painful and red.

  • D. Scleromalacia perforans (correct)

    Correct. Painless thinning in long-standing RA is typical.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Scleromalacia perforans. Scleromalacia perforans is a painless necrotising scleritis without inflammation seen in long-standing seropositive rheumatoid arthritis.

Why is "Episcleritis" not the answer?

Episcleritis does not thin the sclera.

Why is "Posterior scleritis" not the answer?

Posterior scleritis does not give visible thinning anteriorly.

Why is "Necrotising scleritis with inflammation" not the answer?

Necrotising scleritis with inflammation is painful and red.

What concept does this question test?

It tests Sclera: scleromalacia perforans in Ophthalmology. The sclera melts away with the underlying uvea showing through, and perforation is rare. Management is of the underlying disease and protecting the eye from trauma.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Sclera: scleromalacia perforans?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.