Conjunctiva and cornea: ocular cicatricial pemphigoid: 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 · Conjunctiva and cornea: ocular cicatricial pemphigoid

Sample item

A 68-year-old woman has chronic bilateral red eyes, subepithelial fibrosis, shortened fornices and symblepharon. Conjunctival biopsy with immunofluorescence is done. Which finding confirms the diagnosis?

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

The answer and the reasoning

C. Linear IgG and C3 along the basement membrane zone

Ocular cicatricial pemphigoid is an autoimmune subepithelial blistering disease with linear deposition of immunoglobulin and complement at the epithelial basement membrane. Progressive cicatrisation can cause trichiasis, dry eye and blindness.

Option by option

  • A. Granular IgA deposits in the dermal papillae

    Granular IgA in dermal papillae is seen in dermatitis herpetiformis.

  • B. Non-caseating granulomas in the stroma

    Non-caseating granulomas suggest sarcoidosis.

  • C. Linear IgG and C3 along the basement membrane zone (correct)

    Correct. Linear basement membrane deposits are the immunofluorescence hallmark.

  • D. Intraepithelial IgG in a fishnet pattern

    A fishnet intraepithelial pattern is typical of pemphigus, which rarely scars the conjunctiva.

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, Linear IgG and C3 along the basement membrane zone. Ocular cicatricial pemphigoid is an autoimmune subepithelial blistering disease with linear deposition of immunoglobulin and complement at the epithelial basement membrane.

Why is "Granular IgA deposits in the dermal papillae" not the answer?

Granular IgA in dermal papillae is seen in dermatitis herpetiformis.

Why is "Non-caseating granulomas in the stroma" not the answer?

Non-caseating granulomas suggest sarcoidosis.

Why is "Intraepithelial IgG in a fishnet pattern" not the answer?

A fishnet intraepithelial pattern is typical of pemphigus, which rarely scars the conjunctiva.

What concept does this question test?

It tests Conjunctiva and cornea: ocular cicatricial pemphigoid in Ophthalmology. Progressive cicatrisation can cause trichiasis, dry eye and blindness.

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 Conjunctiva and cornea: ocular cicatricial pemphigoid?

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.