Neuro-ophthalmology and pupils: rhino-orbital mucormycosis: 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: rhino-orbital mucormycosis

Sample item

A 55-year-old man with uncontrolled diabetes and ketoacidosis has facial pain, unilateral proptosis, ptosis, complete ophthalmoplegia, loss of vision and a black necrotic eschar over the nasal turbinate. What is the likely diagnosis?

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

The answer and the reasoning

A. Rhino-orbital mucormycosis

Rhino-orbital mucormycosis is an angioinvasive fungal infection seen in ketoacidosis and other immunocompromised states. It invades vessels, producing black necrotic tissue, orbital apex syndrome and rapid vision loss.

Option by option

  • A. Rhino-orbital mucormycosis (correct)

    Correct. Ketoacidosis with a black eschar and orbital apex signs is mucormycosis.

  • B. Tolosa-Hunt syndrome

    Tolosa-Hunt is a painful steroid-responsive granulomatous cavernous sinus inflammation without necrosis.

  • C. Bacterial orbital cellulitis

    Bacterial orbital cellulitis is purulent and does not cause a black necrotic eschar with early ophthalmoplegia.

  • D. Thyroid orbitopathy

    Thyroid orbitopathy gives proptosis and lid retraction without necrosis.

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 A, Rhino-orbital mucormycosis. Rhino-orbital mucormycosis is an angioinvasive fungal infection seen in ketoacidosis and other immunocompromised states.

Why is "Tolosa-Hunt syndrome" not the answer?

Tolosa-Hunt is a painful steroid-responsive granulomatous cavernous sinus inflammation without necrosis.

Why is "Bacterial orbital cellulitis" not the answer?

Bacterial orbital cellulitis is purulent and does not cause a black necrotic eschar with early ophthalmoplegia.

Why is "Thyroid orbitopathy" not the answer?

Thyroid orbitopathy gives proptosis and lid retraction without necrosis.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: rhino-orbital mucormycosis in Ophthalmology. It invades vessels, producing black necrotic tissue, orbital apex syndrome and rapid vision loss.

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: rhino-orbital mucormycosis?

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.