Glaucoma: painful blind eye: 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 · Glaucoma: painful blind eye

Sample item

A 70-year-old has an old neovascular glaucoma in an eye with no perception of light, a pressure of 50 mmHg despite maximal medication, and constant severe pain. Which procedure is most appropriate?

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

The answer and the reasoning

A. Diode laser cyclophotocoagulation

In a blind painful eye the aim is comfort, not vision. Destroying part of the ciliary body with laser reduces aqueous production and relieves pain. Retrobulbar alcohol or evisceration are alternatives when this fails.

Option by option

  • A. Diode laser cyclophotocoagulation (correct)

    Correct. Cyclodestruction lowers aqueous production in a blind painful eye and relieves pain.

  • B. Laser peripheral iridotomy

    Laser iridotomy treats pupillary block, which is not the mechanism of this glaucoma.

  • C. Selective laser trabeculoplasty

    Selective laser trabeculoplasty needs an open angle with working trabecular cells, so it does not help a fibrovascular angle.

  • D. Repeat trabeculectomy with mitomycin C

    Repeat trabeculectomy is a vision-saving operation that has a high failure rate in neovascular eyes.

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.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Diode laser cyclophotocoagulation. In a blind painful eye the aim is comfort, not vision.

Why is "Laser peripheral iridotomy" not the answer?

Laser iridotomy treats pupillary block, which is not the mechanism of this glaucoma.

Why is "Selective laser trabeculoplasty" not the answer?

Selective laser trabeculoplasty needs an open angle with working trabecular cells, so it does not help a fibrovascular angle.

Why is "Repeat trabeculectomy with mitomycin C" not the answer?

Repeat trabeculectomy is a vision-saving operation that has a high failure rate in neovascular eyes.

What concept does this question test?

It tests Glaucoma: painful blind eye in Ophthalmology. Destroying part of the ciliary body with laser reduces aqueous production and relieves pain. Retrobulbar alcohol or evisceration are alternatives when this fails.

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: painful blind eye?

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.