Neuro-ophthalmology and pupils: latent nystagmus: 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 · Neuro-ophthalmology and pupils: latent nystagmus

Sample item

A 4-year-old with infantile esotropia has a jerk nystagmus that appears only when one eye is covered, and its fast phase beats towards the uncovered eye. What is this nystagmus?

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

The answer and the reasoning

A. Latent nystagmus

Latent (fusion maldevelopment) nystagmus is associated with infantile strabismus and appears or increases when one eye is occluded, with the fast phase towards the fixing eye. It makes testing of acuity with occlusion unreliable.

Option by option

  • A. Latent nystagmus (correct)

    Correct. Nystagmus brought out by covering one eye is latent nystagmus.

  • B. Spasmus nutans

    Spasmus nutans has head nodding and asymmetric small-amplitude pendular movements.

  • C. Vestibular nystagmus

    Vestibular nystagmus follows labyrinthine or brainstem disease with vertigo.

  • D. Congenital motor nystagmus

    Congenital motor nystagmus is present with both eyes open and is conjugate.

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 A, Latent nystagmus. Latent (fusion maldevelopment) nystagmus is associated with infantile strabismus and appears or increases when one eye is occluded, with the fast phase towards the fixing eye.

Why is "Spasmus nutans" not the answer?

Spasmus nutans has head nodding and asymmetric small-amplitude pendular movements.

Why is "Vestibular nystagmus" not the answer?

Vestibular nystagmus follows labyrinthine or brainstem disease with vertigo.

Why is "Congenital motor nystagmus" not the answer?

Congenital motor nystagmus is present with both eyes open and is conjugate.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: latent nystagmus in Ophthalmology. It makes testing of acuity with occlusion unreliable.

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 Neuro-ophthalmology and pupils: latent nystagmus?

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.