Glaucoma: angle-recession glaucoma: 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.

Try it

Ophthalmology · Glaucoma: angle-recession glaucoma

Sample item

A 40-year-old man was hit in the left eye by a shuttlecock 12 years ago. He now has an intraocular pressure of 32 mmHg in that eye, although the angle looks open. Which gonioscopic finding best explains the pressure rise?

AA wavy pigment line anterior to Schwalbe lineBFine new vessels crossing the scleral spurCBroad synechiae extending up to Schwalbe lineDA widened ciliary body band with torn iris processes

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

The answer and the reasoning

D. A widened ciliary body band with torn iris processes

Blunt trauma can tear the ciliary body between its longitudinal and circular muscle layers, which widens the visible ciliary body band. Later scarring of the trabecular meshwork raises the pressure, sometimes years after the injury. The fellow eye is also at increased risk of open-angle glaucoma.

Option by option

A. A wavy pigment line anterior to Schwalbe line
A wavy pigment line anterior to Schwalbe line is the Sampaolesi line of pseudoexfoliation, not a result of blunt trauma.
B. Fine new vessels crossing the scleral spur
New vessels crossing the scleral spur indicate neovascular glaucoma after retinal ischaemia.
C. Broad synechiae extending up to Schwalbe line
Broad synechiae reaching Schwalbe line indicate synechial angle closure, but this angle is described as open.
D. A widened ciliary body band with torn iris processes (correct)
Correct. A widened ciliary body band marks angle recession, and the late trabecular scarring causes the raised pressure.

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.

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, A widened ciliary body band with torn iris processes. Blunt trauma can tear the ciliary body between its longitudinal and circular muscle layers, which widens the visible ciliary body band.

Why is "A wavy pigment line anterior to Schwalbe line" not the answer?

A wavy pigment line anterior to Schwalbe line is the Sampaolesi line of pseudoexfoliation, not a result of blunt trauma.

Why is "Fine new vessels crossing the scleral spur" not the answer?

New vessels crossing the scleral spur indicate neovascular glaucoma after retinal ischaemia.

Why is "Broad synechiae extending up to Schwalbe line" not the answer?

Broad synechiae reaching Schwalbe line indicate synechial angle closure, but this angle is described as open.

What concept does this question test?

It tests Glaucoma: angle-recession glaucoma in Ophthalmology. Later scarring of the trabecular meshwork raises the pressure, sometimes years after the injury. The fellow eye is also at increased risk of open-angle glaucoma.

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 Glaucoma: angle-recession glaucoma?

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.