Conjunctiva and cornea: Peters anomaly: 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: Peters anomaly

Sample item

A newborn has a dense central corneal opacity in both eyes. Slit lamp shows iris strands running from the collarette to the edge of the opacity, and a posterior corneal defect. What is the most likely diagnosis?

ASclerocorneaBCongenital hereditary endothelial dystrophyCAxenfeld anomalyDPeters anomaly

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

The answer and the reasoning

D. Peters anomaly

Peters anomaly is a central corneal leucoma with a defect of the posterior stroma, Descemet membrane and endothelium, with iris or lens adhesions to the back of the opacity. Glaucoma is a common associated problem, so it needs early assessment of pressure and visual rehabilitation.

Option by option

A. Sclerocornea
Sclerocornea is peripheral or total scleralisation of the cornea, without the central posterior defect and iris strands.
B. Congenital hereditary endothelial dystrophy
Congenital hereditary endothelial dystrophy gives diffuse ground-glass oedema, not a discrete central opacity with iris strands.
C. Axenfeld anomaly
Axenfeld anomaly has a prominent anterior Schwalbe line with peripheral iris strands, and the central cornea is clear.
D. Peters anomaly (correct)
Correct. A central opacity with a posterior corneal defect and iris adhesions defines Peters anomaly.

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 D, Peters anomaly. Peters anomaly is a central corneal leucoma with a defect of the posterior stroma, Descemet membrane and endothelium, with iris or lens adhesions to the back of the opacity.

Why is "Sclerocornea" not the answer?

Sclerocornea is peripheral or total scleralisation of the cornea, without the central posterior defect and iris strands.

Why is "Congenital hereditary endothelial dystrophy" not the answer?

Congenital hereditary endothelial dystrophy gives diffuse ground-glass oedema, not a discrete central opacity with iris strands.

Why is "Axenfeld anomaly" not the answer?

Axenfeld anomaly has a prominent anterior Schwalbe line with peripheral iris strands, and the central cornea is clear.

What concept does this question test?

It tests Conjunctiva and cornea: Peters anomaly in Ophthalmology. Glaucoma is a common associated problem, so it needs early assessment of pressure and visual rehabilitation.

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 Conjunctiva and cornea: Peters anomaly?

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.