Retina: retinoschisis versus detachment: 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 · Retina: retinoschisis versus detachment

Sample item

A 65-year-old hypermetropic man has a smooth, dome-shaped, transparent elevation in the inferotemporal periphery. There are no retinal breaks in the outer layer, no tobacco dust in the vitreous and the lesion does not shift with posture. Perimetry corresponding to the lesion is most likely to show what?

AA central scotoma with a normal peripheryBAn absolute scotomaCA superior altitudinal defectDA relative scotoma

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

The answer and the reasoning

B. An absolute scotoma

In senile retinoschisis the retina splits into two layers, so the photoreceptors in the area are separated from the inner layer and the sensitivity is absent. This produces an absolute scotoma, unlike a detached retina where the defect is relative because the receptors still function partly. The lesion is smooth, immobile and usually stable.

Option by option

A. A central scotoma with a normal periphery
A central scotoma with a normal periphery points to macular or optic nerve disease rather than a peripheral lesion.
B. An absolute scotoma (correct)
Correct. Splitting of the retinal layers gives an absolute field defect in the area of the schisis.
C. A superior altitudinal defect
An altitudinal defect fits an ischaemic optic neuropathy or a branch vascular occlusion, not a peripheral split of the retina.
D. A relative scotoma
A relative scotoma is the typical finding in a rhegmatogenous detachment.

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, An absolute scotoma. In senile retinoschisis the retina splits into two layers, so the photoreceptors in the area are separated from the inner layer and the sensitivity is absent.

Why is "A central scotoma with a normal periphery" not the answer?

A central scotoma with a normal periphery points to macular or optic nerve disease rather than a peripheral lesion.

Why is "A superior altitudinal defect" not the answer?

An altitudinal defect fits an ischaemic optic neuropathy or a branch vascular occlusion, not a peripheral split of the retina.

Why is "A relative scotoma" not the answer?

A relative scotoma is the typical finding in a rhegmatogenous detachment.

What concept does this question test?

It tests Retina: retinoschisis versus detachment in Ophthalmology. This produces an absolute scotoma, unlike a detached retina where the defect is relative because the receptors still function partly. The lesion is smooth, immobile and usually stable.

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 Retina: retinoschisis versus detachment?

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.