Anatomy and physiology of the eye: absent follicles in neonates: 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 · Anatomy and physiology of the eye: absent follicles in neonates

Sample item

A 10-day-old baby with conjunctivitis due to Chlamydia trachomatis shows papillae but no follicles. Why do follicles not form at this age?

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

The answer and the reasoning

C. The conjunctival adenoid layer is not yet developed

The adenoid (lymphoid) layer of the conjunctiva develops only after about three months of life, so neonates cannot mount a follicular response. This is why neonatal inclusion conjunctivitis is papillary.

Option by option

  • A. Accessory lacrimal glands are not yet present

    Accessory glands are present and do not determine the follicular response.

  • B. The conjunctival epithelium is too thick

    The neonatal epithelium is thin and does not prevent follicle formation.

  • C. The conjunctival adenoid layer is not yet developed (correct)

    Correct. Lymphoid tissue needed for follicles is not present at birth.

  • D. Goblet cells are absent until adulthood

    Goblet cells are present early and are unrelated to follicle formation.

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, The conjunctival adenoid layer is not yet developed. The adenoid (lymphoid) layer of the conjunctiva develops only after about three months of life, so neonates cannot mount a follicular response.

Why is "Accessory lacrimal glands are not yet present" not the answer?

Accessory glands are present and do not determine the follicular response.

Why is "The conjunctival epithelium is too thick" not the answer?

The neonatal epithelium is thin and does not prevent follicle formation.

Why is "Goblet cells are absent until adulthood" not the answer?

Goblet cells are present early and are unrelated to follicle formation.

What concept does this question test?

It tests Anatomy and physiology of the eye: absent follicles in neonates in Ophthalmology. This is why neonatal inclusion conjunctivitis is papillary.

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 Anatomy and physiology of the eye: absent follicles in neonates?

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.