Glaucoma: Van Herick grading: 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 · Glaucoma: Van Herick grading

Sample item

On slit-lamp examination the peripheral anterior chamber depth is less than one quarter of the adjacent corneal thickness. What is the interpretation?

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

The answer and the reasoning

A. Narrow angle at risk of closure (grade 2 or less)

Van Herick estimates the peripheral chamber depth as a fraction of corneal thickness: grade 2 is one quarter of corneal thickness and grade 1 is less than a quarter. Grades 1 and 2 are considered occludable and warrant gonioscopy.

Option by option

  • A. Narrow angle at risk of closure (grade 2 or less) (correct)

    Correct. A quarter or less suggests a narrow, occludable angle.

  • B. Normal angle (grade 3 to 4)

    Grades 3 and 4 are safe.

  • C. Angle recession

    Angle recession is shown by a widened ciliary band on gonioscopy.

  • D. Wide open angle (grade 4)

    Wide angles have a depth of one corneal thickness or more.

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 A, Narrow angle at risk of closure (grade 2 or less). Van Herick estimates the peripheral chamber depth as a fraction of corneal thickness: grade 2 is one quarter of corneal thickness and grade 1 is less than a quarter.

Why is "Normal angle (grade 3 to 4)" not the answer?

Grades 3 and 4 are safe.

Why is "Angle recession" not the answer?

Angle recession is shown by a widened ciliary band on gonioscopy.

Why is "Wide open angle (grade 4)" not the answer?

Wide angles have a depth of one corneal thickness or more.

What concept does this question test?

It tests Glaucoma: Van Herick grading in Ophthalmology. Grades 1 and 2 are considered occludable and warrant gonioscopy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Glaucoma: Van Herick grading?

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.