Uvea: cytomegalovirus anterior uveitis: 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 · Uvea: cytomegalovirus anterior uveitis

Sample item

A 45-year-old immunocompetent man has recurrent unilateral episodes of raised pressure with coin-shaped keratic precipitates and sectoral iris atrophy. Topical steroids alone fail to control the problem. Which test best identifies the cause?

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

The answer and the reasoning

B. Polymerase chain reaction on aqueous humour

Cytomegalovirus can cause a hypertensive anterior uveitis resembling Posner-Schlossman syndrome, with coin-shaped precipitates and iris atrophy. Aqueous sampling for viral DNA confirms it, and treatment is with antiviral therapy such as ganciclovir.

Option by option

  • A. HLA-B27 typing

    HLA-B27 typing supports a non-infective acute anterior uveitis, not this pattern with coin-shaped precipitates.

  • B. Polymerase chain reaction on aqueous humour (correct)

    Correct. Polymerase chain reaction on a small aqueous sample can detect viral DNA and guide antiviral treatment.

  • C. Tuberculin skin test

    A tuberculin test would support tuberculous uveitis, which does not give this pattern.

  • D. Serum angiotensin-converting enzyme level

    Serum angiotensin-converting enzyme supports sarcoidosis, which causes granulomatous inflammation with mutton-fat precipitates.

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, Polymerase chain reaction on aqueous humour. Cytomegalovirus can cause a hypertensive anterior uveitis resembling Posner-Schlossman syndrome, with coin-shaped precipitates and iris atrophy.

Why is "HLA-B27 typing" not the answer?

HLA-B27 typing supports a non-infective acute anterior uveitis, not this pattern with coin-shaped precipitates.

Why is "Tuberculin skin test" not the answer?

A tuberculin test would support tuberculous uveitis, which does not give this pattern.

Why is "Serum angiotensin-converting enzyme level" not the answer?

Serum angiotensin-converting enzyme supports sarcoidosis, which causes granulomatous inflammation with mutton-fat precipitates.

What concept does this question test?

It tests Uvea: cytomegalovirus anterior uveitis in Ophthalmology. Aqueous sampling for viral DNA confirms it, and treatment is with antiviral therapy such as ganciclovir.

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 Uvea: cytomegalovirus anterior uveitis?

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.