Conjunctiva and cornea: exposure keratopathy in facial palsy: 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: exposure keratopathy in facial palsy

Sample item

A man with Bell palsy cannot close his right eye fully and has punctate fluorescein staining of the inferior cornea on waking. What is the best initial treatment?

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

The answer and the reasoning

B. Lubricating ointment at night with lid taping

Lagophthalmos causes exposure keratopathy, which is prevented by frequent lubricants, ointment at night and taping or moisture chambers. A pressure patch would be dangerous because the lids cannot hold the patch away from the cornea.

Option by option

  • A. Topical NSAID drops

    NSAID drops do not treat exposure and may impair healing.

  • B. Lubricating ointment at night with lid taping (correct)

    Correct. Lubrication and lid closure protect the exposed cornea.

  • C. Topical corticosteroid drops

    Steroids do not address exposure and risk infection and melt.

  • D. Firm pressure patching

    Pressure patching can abrade the cornea when the patient cannot blink normally.

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 B, Lubricating ointment at night with lid taping. Lagophthalmos causes exposure keratopathy, which is prevented by frequent lubricants, ointment at night and taping or moisture chambers.

Why is "Topical NSAID drops" not the answer?

NSAID drops do not treat exposure and may impair healing.

Why is "Topical corticosteroid drops" not the answer?

Steroids do not address exposure and risk infection and melt.

Why is "Firm pressure patching" not the answer?

Pressure patching can abrade the cornea when the patient cannot blink normally.

What concept does this question test?

It tests Conjunctiva and cornea: exposure keratopathy in facial palsy in Ophthalmology. A pressure patch would be dangerous because the lids cannot hold the patch away from the cornea.

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 Conjunctiva and cornea: exposure keratopathy in facial palsy?

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.