Uvea: herpes zoster uveitis management: 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: herpes zoster uveitis management

Sample item

A 50-year-old with earlier vesicles over the forehead and tip of the nose now has a red eye with raised pressure, reduced corneal sensation and sectoral iris atrophy. What is the best treatment?

AOral methotrexate as a steroid-sparing agentBTopical steroid with oral acyclovir cover and pressure-lowering dropsCTopical steroid alone, tapered quicklyDTopical pilocarpine to reduce pressure

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

The answer and the reasoning

B. Topical steroid with oral acyclovir cover and pressure-lowering drops

Zoster uveitis is an inflammatory response to viral antigen, so topical steroids are needed, but they are given with antiviral cover to prevent viral flare. The raised pressure needs treatment, using drugs other than miotics, which worsen inflammation.

Option by option

A. Oral methotrexate as a steroid-sparing agent
Methotrexate is a long-term immunosuppressant and not the treatment of an acute viral uveitis.
B. Topical steroid with oral acyclovir cover and pressure-lowering drops (correct)
Correct. Steroid controls the inflammation, antiviral cover limits viral activity, and pressure is treated alongside.
C. Topical steroid alone, tapered quickly
Steroid alone leaves viral replication uncovered and risks reactivation.
D. Topical pilocarpine to reduce pressure
Pilocarpine is a miotic that increases inflammation and synechiae in uveitis.

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 B, Topical steroid with oral acyclovir cover and pressure-lowering drops. Zoster uveitis is an inflammatory response to viral antigen, so topical steroids are needed, but they are given with antiviral cover to prevent viral flare.

Why is "Oral methotrexate as a steroid-sparing agent" not the answer?

Methotrexate is a long-term immunosuppressant and not the treatment of an acute viral uveitis.

Why is "Topical steroid alone, tapered quickly" not the answer?

Steroid alone leaves viral replication uncovered and risks reactivation.

Why is "Topical pilocarpine to reduce pressure" not the answer?

Pilocarpine is a miotic that increases inflammation and synechiae in uveitis.

What concept does this question test?

It tests Uvea: herpes zoster uveitis management in Ophthalmology. The raised pressure needs treatment, using drugs other than miotics, which worsen inflammation.

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: herpes zoster uveitis management?

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.