Glaucoma: reversible cupping in infants: 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: reversible cupping in infants

Sample item

After a successful goniotomy in an infant with raised pressure, the enlarged optic disc cup becomes smaller on follow-up. Why can cupping regress in infants but not in adults?

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

The answer and the reasoning

C. The infant scleral canal and lamina cribrosa are elastic and recoil

In young eyes the scleral canal and lamina cribrosa are distensible, so a raised pressure stretches them and a fall in pressure lets them recoil. In adults the tissues are rigid and the cup reflects permanent axonal loss. Regression of cupping is therefore a useful sign of control in infants.

Option by option

  • A. Infant eyes make less aqueous after surgery

    Aqueous production is not the reason the cup changes shape, and it is not reduced by goniotomy.

  • B. Glial tissue fills the cup in infants

    Glial filling would produce permanent pallor, not true regression of the cup.

  • C. The infant scleral canal and lamina cribrosa are elastic and recoil (correct)

    Correct. Elastic tissues stretched by high pressure can recoil, so the cup shrinks in infants.

  • D. Infant ganglion cells regenerate once pressure falls

    Retinal ganglion cells do not regenerate in infants, and the change is mechanical.

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 C, The infant scleral canal and lamina cribrosa are elastic and recoil. In young eyes the scleral canal and lamina cribrosa are distensible, so a raised pressure stretches them and a fall in pressure lets them recoil.

Why is "Infant eyes make less aqueous after surgery" not the answer?

Aqueous production is not the reason the cup changes shape, and it is not reduced by goniotomy.

Why is "Glial tissue fills the cup in infants" not the answer?

Glial filling would produce permanent pallor, not true regression of the cup.

Why is "Infant ganglion cells regenerate once pressure falls" not the answer?

Retinal ganglion cells do not regenerate in infants, and the change is mechanical.

What concept does this question test?

It tests Glaucoma: reversible cupping in infants in Ophthalmology. In adults the tissues are rigid and the cup reflects permanent axonal loss. Regression of cupping is therefore a useful sign of control in infants.

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 Glaucoma: reversible cupping in infants?

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.