Conjunctiva and cornea: macular corneal dystrophy: 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 · Conjunctiva and cornea: macular corneal dystrophy

Sample item

A 20-year-old has progressive bilateral corneal clouding that extends right out to the limbus, with diffuse haze between grey-white spots. His parents are unaffected and the abnormal stromal material stains with Alcian blue and colloidal iron. Which dystrophy is this?

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

The answer and the reasoning

D. Macular dystrophy

Macular dystrophy is the only common stromal dystrophy inherited as an autosomal recessive trait. It deposits abnormal glycosaminoglycan (keratan sulphate) that stains with Alcian blue and colloidal iron, and haze involves the whole stroma up to the limbus.

Option by option

  • A. Granular dystrophy

    Granular dystrophy is autosomal dominant, stains with Masson trichrome and has clear stroma between discrete opacities.

  • B. Lattice dystrophy

    Lattice dystrophy is autosomal dominant with amyloid that stains with Congo red.

  • C. Reis-Bucklers dystrophy

    Reis-Bucklers dystrophy is an autosomal dominant disease of Bowman's layer, not a recessive stromal dystrophy.

  • D. Macular dystrophy (correct)

    Correct. Recessive inheritance and glycosaminoglycan staining with diffuse haze to the limbus identify macular dystrophy.

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, Macular dystrophy. Macular dystrophy is the only common stromal dystrophy inherited as an autosomal recessive trait.

Why is "Granular dystrophy" not the answer?

Granular dystrophy is autosomal dominant, stains with Masson trichrome and has clear stroma between discrete opacities.

Why is "Lattice dystrophy" not the answer?

Lattice dystrophy is autosomal dominant with amyloid that stains with Congo red.

Why is "Reis-Bucklers dystrophy" not the answer?

Reis-Bucklers dystrophy is an autosomal dominant disease of Bowman's layer, not a recessive stromal dystrophy.

What concept does this question test?

It tests Conjunctiva and cornea: macular corneal dystrophy in Ophthalmology. It deposits abnormal glycosaminoglycan (keratan sulphate) that stains with Alcian blue and colloidal iron, and haze involves the whole stroma up to the limbus.

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 Conjunctiva and cornea: macular corneal dystrophy?

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.