Glaucoma: pilocarpine mechanism: 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.

Try it

Ophthalmology · Glaucoma: pilocarpine mechanism

Sample item

How does pilocarpine lower IOP in open angle glaucoma?

AReducing aqueous secretionBReducing episcleral venous pressureCCiliary muscle contraction pulling on the scleral spur to open trabecular meshworkDIncreasing uveoscleral outflow

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

The answer and the reasoning

C. Ciliary muscle contraction pulling on the scleral spur to open trabecular meshwork

Pilocarpine is a muscarinic agonist that contracts the ciliary muscle and improves trabecular outflow, and also causes miosis and accommodative spasm. It is useful for opening the angle in angle closure after iridotomy. It reduces dim light vision.

Option by option

A. Reducing aqueous secretion
Beta blockers and CAIs reduce secretion.
B. Reducing episcleral venous pressure
Netarsudil reduces episcleral venous pressure.
C. Ciliary muscle contraction pulling on the scleral spur to open trabecular meshwork (correct)
Correct. Increased trabecular outflow is the mechanism.
D. Increasing uveoscleral outflow
Prostaglandins increase uveoscleral outflow.

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.

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Ciliary muscle contraction pulling on the scleral spur to open trabecular meshwork. Pilocarpine is a muscarinic agonist that contracts the ciliary muscle and improves trabecular outflow, and also causes miosis and accommodative spasm.

Why is "Reducing aqueous secretion" not the answer?

Beta blockers and CAIs reduce secretion.

Why is "Reducing episcleral venous pressure" not the answer?

Netarsudil reduces episcleral venous pressure.

Why is "Increasing uveoscleral outflow" not the answer?

Prostaglandins increase uveoscleral outflow.

What concept does this question test?

It tests Glaucoma: pilocarpine mechanism in Ophthalmology. It is useful for opening the angle in angle closure after iridotomy. It reduces dim light vision.

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: pilocarpine mechanism?

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.