Glaucoma: topical carbonic anhydrase inhibitor and endothelium: 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: topical carbonic anhydrase inhibitor and endothelium

Sample item

A patient with Fuchs endothelial dystrophy needs a pressure-lowering drop. Which topical class carries a risk of corneal decompensation in such eyes?

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

The answer and the reasoning

B. Carbonic anhydrase inhibitors

Carbonic anhydrase is part of the endothelial pump that keeps the cornea dehydrated, and topical inhibitors can tip a compromised endothelium into oedema. Such eyes are better treated with a different class, with the corneal thickness followed.

Option by option

  • A. Beta-blockers

    Beta-blockers reduce aqueous formation but do not impair the endothelial pump.

  • B. Carbonic anhydrase inhibitors (correct)

    Correct. Inhibiting carbonic anhydrase can reduce endothelial pump function in an eye with few reserve endothelial cells.

  • C. Prostaglandin analogues

    Prostaglandin analogues act by uveoscleral outflow and do not impair the endothelial pump.

  • D. Alpha-2 agonists

    Alpha-2 agonists reduce aqueous formation and increase uveoscleral outflow, with no effect on the endothelial pump.

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, Carbonic anhydrase inhibitors. Carbonic anhydrase is part of the endothelial pump that keeps the cornea dehydrated, and topical inhibitors can tip a compromised endothelium into oedema.

Why is "Beta-blockers" not the answer?

Beta-blockers reduce aqueous formation but do not impair the endothelial pump.

Why is "Prostaglandin analogues" not the answer?

Prostaglandin analogues act by uveoscleral outflow and do not impair the endothelial pump.

Why is "Alpha-2 agonists" not the answer?

Alpha-2 agonists reduce aqueous formation and increase uveoscleral outflow, with no effect on the endothelial pump.

What concept does this question test?

It tests Glaucoma: topical carbonic anhydrase inhibitor and endothelium in Ophthalmology. Such eyes are better treated with a different class, with the corneal thickness followed.

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: topical carbonic anhydrase inhibitor and endothelium?

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.