Neuro-ophthalmology and pupils: intermittent exotropia: 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: intermittent exotropia

Sample item

A 5-year-old closes one eye in bright sunlight. The eyes are straight at near but drift outwards when the child looks at distant objects or is tired, with good vision in each eye. What is the likely diagnosis?

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

The answer and the reasoning

D. Intermittent exotropia

Intermittent exotropia is the commonest exodeviation in childhood. It is worse at distance, in bright light and with fatigue, and children often close one eye in sunlight. Treatment depends on frequency and control, from observation to surgery.

Option by option

  • A. Convergence insufficiency

    Convergence insufficiency causes an exodeviation and symptoms mainly at near.

  • B. Third nerve palsy

    Third nerve palsy produces a constant exotropia with ptosis and limited movement.

  • C. Infantile esotropia

    Infantile esotropia is an inward, large angle, constant squint with onset before 6 months.

  • D. Intermittent exotropia (correct)

    Correct. Distance-predominant intermittent outward drift with eye closure in sunlight is typical.

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, Intermittent exotropia. Intermittent exotropia is the commonest exodeviation in childhood.

Why is "Convergence insufficiency" not the answer?

Convergence insufficiency causes an exodeviation and symptoms mainly at near.

Why is "Third nerve palsy" not the answer?

Third nerve palsy produces a constant exotropia with ptosis and limited movement.

Why is "Infantile esotropia" not the answer?

Infantile esotropia is an inward, large angle, constant squint with onset before 6 months.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: intermittent exotropia in Ophthalmology. It is worse at distance, in bright light and with fatigue, and children often close one eye in sunlight. Treatment depends on frequency and control, from observation to surgery.

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: intermittent exotropia?

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.