Glaucoma: management of the fellow 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.

Try it

Ophthalmology · Glaucoma: management of the fellow eye

Sample item

A woman has had an acute angle-closure attack in her right eye, treated with laser iridotomy. Her left eye is quiet but has an equally narrow angle. What is the best management for the left eye?

AProphylactic laser peripheral iridotomyBObservation with yearly reviewCLong-term topical timololDLong-term pilocarpine drops

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

The answer and the reasoning

A. Prophylactic laser peripheral iridotomy

The fellow eye of a patient who has had acute angle closure has a high chance of an attack within a few years because the anatomy is shared. A prophylactic iridotomy removes the pupillary block and is the standard preventive step.

Option by option

A. Prophylactic laser peripheral iridotomy (correct)
Correct. Prophylactic iridotomy removes pupillary block in the eye at risk.
B. Observation with yearly review
Observation alone leaves a shared anatomical risk of an attack untreated.
C. Long-term topical timolol
Timolol lowers pressure but does not prevent the pupillary block that produces the attack.
D. Long-term pilocarpine drops
Long-term pilocarpine is not an acceptable substitute because it is poorly tolerated and does not remove the block.

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 A, Prophylactic laser peripheral iridotomy. The fellow eye of a patient who has had acute angle closure has a high chance of an attack within a few years because the anatomy is shared.

Why is "Observation with yearly review" not the answer?

Observation alone leaves a shared anatomical risk of an attack untreated.

Why is "Long-term topical timolol" not the answer?

Timolol lowers pressure but does not prevent the pupillary block that produces the attack.

Why is "Long-term pilocarpine drops" not the answer?

Long-term pilocarpine is not an acceptable substitute because it is poorly tolerated and does not remove the block.

What concept does this question test?

It tests Glaucoma: management of the fellow eye in Ophthalmology. A prophylactic iridotomy removes the pupillary block and is the standard preventive step.

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: management of the fellow 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.