Retina: ocular ischaemic syndrome: 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 · Retina: ocular ischaemic syndrome

Sample item

A 68-year-old diabetic smoker has dull ocular pain and a unilateral picture of mid-peripheral dot-blot haemorrhages, narrowed arterioles, dilated non-tortuous veins, spontaneous arterial pulsation on the disc and a history of amaurosis fugax. Which is the underlying problem?

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

The answer and the reasoning

C. Ipsilateral carotid artery occlusive disease

Ocular ischaemic syndrome results from chronic ocular hypoperfusion due to severe ipsilateral carotid stenosis or occlusion. Findings include mid-peripheral haemorrhages, narrowed arteries, dilated veins and retinal arterial pulsation. Carotid assessment is needed.

Option by option

  • A. Bilateral symmetric proliferative diabetic retinopathy

    Proliferative diabetic retinopathy is bilateral and symmetric and does not show arterial pulsation.

  • B. Non-ischaemic central retinal vein occlusion

    Non-ischaemic CRVO has tortuous, engorged veins with disc swelling and widespread haemorrhages.

  • C. Ipsilateral carotid artery occlusive disease (correct)

    Correct. Carotid occlusive disease reduces ocular perfusion.

  • D. Raised intracranial pressure

    Raised intracranial pressure gives bilateral papilloedema and does not cause arterial pulsation.

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 C, Ipsilateral carotid artery occlusive disease. Ocular ischaemic syndrome results from chronic ocular hypoperfusion due to severe ipsilateral carotid stenosis or occlusion.

Why is "Bilateral symmetric proliferative diabetic retinopathy" not the answer?

Proliferative diabetic retinopathy is bilateral and symmetric and does not show arterial pulsation.

Why is "Non-ischaemic central retinal vein occlusion" not the answer?

Non-ischaemic CRVO has tortuous, engorged veins with disc swelling and widespread haemorrhages.

Why is "Raised intracranial pressure" not the answer?

Raised intracranial pressure gives bilateral papilloedema and does not cause arterial pulsation.

What concept does this question test?

It tests Retina: ocular ischaemic syndrome in Ophthalmology. Findings include mid-peripheral haemorrhages, narrowed arteries, dilated veins and retinal arterial pulsation. Carotid assessment is needed.

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 Retina: ocular ischaemic syndrome?

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.