Sclera: scleritis: 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: scleritis

Sample item

A 55-year-old woman with rheumatoid arthritis has a severe, deep, boring eye pain that wakes her at night and radiates to the brow. The eye is red with a violaceous hue and tenderness. After instilling 10% phenylephrine, the redness does not blanch. What is the diagnosis?

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

The answer and the reasoning

C. Scleritis

Scleritis is inflammation of the sclera, often associated with rheumatoid arthritis, granulomatosis with polyangiitis or other systemic vasculitis. It causes severe boring pain, a deep violaceous redness that does not blanch with phenylephrine, and a risk of scleral thinning (scleromalacia) and perforation. Treatment is systemic NSAIDs or corticosteroids, with immunosuppression for necrotising disease. Episcleritis is milder, with superficial vessels that blanch.

Option by option

  • A. Acute angle-closure glaucoma

    Angle-closure glaucoma causes a fixed mid-dilated pupil, a hazy cornea and very high pressure.

  • B. Acute conjunctivitis

    Conjunctivitis produces discharge and gritty irritation, not severe boring pain.

  • C. Scleritis (correct)

    Correct. Deep, non-blanching redness with severe night pain is typical of scleritis.

  • D. Episcleritis

    Episcleritis causes mild discomfort and superficial redness that blanches with phenylephrine.

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.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Scleritis. Scleritis is inflammation of the sclera, often associated with rheumatoid arthritis, granulomatosis with polyangiitis or other systemic vasculitis.

Why is "Acute angle-closure glaucoma" not the answer?

Angle-closure glaucoma causes a fixed mid-dilated pupil, a hazy cornea and very high pressure.

Why is "Acute conjunctivitis" not the answer?

Conjunctivitis produces discharge and gritty irritation, not severe boring pain.

Why is "Episcleritis" not the answer?

Episcleritis causes mild discomfort and superficial redness that blanches with phenylephrine.

What concept does this question test?

It tests Sclera: scleritis in Ophthalmology. It causes severe boring pain, a deep violaceous redness that does not blanch with phenylephrine, and a risk of scleral thinning (scleromalacia) and perforation. Treatment is systemic NSAIDs or corticosteroids, with immunosuppression for necrotising disease. Episcleritis is milder, with superficial vessels that blanch.

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 Sclera: scleritis?

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.